Teresa L Mendenhall, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041273223 Issued in IL

Practice address

16342 N Il Hwy 37
Mount Vernon, IL 62864

Phone

(618) 242-1510

Fax

(618) 242-0958

NPI assigned

Apr 10, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1235372954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640054",
            "telephone_number": "618-242-1510",
            "fax_number": "618-242-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16342 N IL HWY 37",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-242-1510",
            "fax_number": "618-242-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "TERESA",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041273223",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Midwest Emergency Good Samaritan, Inc
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• Registered Nurse in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.